Non-lab based projects

Non Laboratory based Honours and Masters Projects offered in 2018.

Projects listed below are ordered by Research Theme. Projects are available as Honours, and when available marked as Masters above the project description. If a project is offered as Masters only it is clearly marked as such.

Laboratory based Research Projects are found here.

Download a pdf copy of the 2018 Honours/Masters Handbook here.

Students are encouraged to directly contact Supervisors to further discuss the project, including providing a CV and academic transcripts to help the Supervisor determine if they are a suitable candidate.

Students should confirm their interest in the project with the Supervisor before nominating the project in their University application. Ensure the correct number corresponding to the project title is nominated for Department of Paediatrics in HATS.

Projects by Theme:

 

Clinical Sciences

37. Investigation of inter-arm blood pressure differences during paediatric exercise testing

38. Haemostatic abnormalities in children with venous thromboembolism and stroke

39. Understanding brain development in ADHD using longitudinal, multimodal neuroimaging

40. Peak exercise capacity in patients with a Fontan circulation

41. Placental dysfunction in the causal pathway to cerebral palsy

42. Cardiovascular Risk in Nephrotic Syndrome

60. A qualitative study exploring physical activity in children with a Fontan circulation

61. Understanding prognosis for children diagnosed with autism spectrum disorder

62. Characterising Autism Spectrum Disorder in identical twins

63. How do we help sick babies breath? Understanding the role of ventilator synchronisation on lung protection

 

Data Science

64. Machine learning methods for causal inference in epidemiology: Application to the effects of cannabis use on mental health

65. Evaluation and development of approaches for conducting sensitivity analyses within the multiple imputation framework

 

Genetics

43. What are the education and training needs of health professionals incorporating genomics into healthcare? A mixed methods study

44. Susceptibility to adult disorders in carriers of Mendelian alleles

45. Burden of disease associated with genetic aetiology at a paediatric hospital 

66. Developing new sensitive outcome measures for assessment of gait in children and adolescents with Angelman syndrome

 

Infection and Immunity

46. BiliNappy: Novel low cost point-of-care diagnostic for Jaundice embedded in a newborn nappy 

47. Risk factors associated with pneumococcal carriage in healthy children in Mongolia prior to pneumococcal conjugate vaccine introduction

54. Biomarkers of human papillomavirus-related cancers

 

Population Health

48. What influences mental health treatment choices for children in Australia? A qualitative study of family and clinician factors.

49. The epidemiology of childhood food allergy and other allergic diseases

50. Measuring low value care across inpatient, outpatient and emergency department settings

51. Measuring low value care in the emergency department; a multi-site study

52. The feasibility and acceptability of a mindfulness meditation program within the preschool setting 

53. The 'Premmie Health Profile': Do babies born early or small have distinct patterns of health and metabolic disparities?

55. The "Best Age and Size to be Born": Is there an optimal gestational age and size for later child health, and does this vary by specific health and metabolic outcome?

56. What does it cost to do research with women experiencing adversity?

57. Understanding patterns of social adversity from pregnancy to school-entry

58. How is hair cortisol related to mother's mental health and wellbeing over time?

59. Validating a generic mood question in a large cohort of Australian women

Project Descriptions:

Clinical Sciences

37. Investigation of inter-arm blood pressure differences during paediatric exercise testing

Available as Masters Project: No

Blood pressure provides important information about cardiovascular health in children. In the Cardiology clinic at the Royal Children's Hospital, blood pressure is routinely measured before and after exercise testing to assess the heart's response to stress; this can reveal problems that may not be detectable under resting conditions. Previous studies have shown that the blood pressure response to exercise in children provides important information about current heart health and also the risk of developing cardiovascular problems in the future. Blood pressure is currently measured in one arm, but studies in adults have shown that, during exercise, about one third of individuals display an interarm blood pressure difference (i.e. a significantly higher pressure in one arm compared with the other). There is also evidence in adults that interarm blood pressure differences are indicative of an elevated risk of mortality. Although current guidelines suggest blood pressure should be measured in both arms, this recommendation is rarely followed in practice. The aims of this project are to i) establish the existence and frequency of interarm blood pressure differences in children at rest and after exercise, ii) investigate whether such differences are more prevalent in normal children versus those with diagnosed cardiovascular disease and iii) investigate the potential physiological mechanisms underlying interarm blood pressure differences. This study may lead to a stronger rationale for measuring blood pressure in both arms, thus leading to a measurable impact on clinical practice.

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38. Haemostatic abnormalities in children with venous thromboembolism and stroke

Professor Paul Monagle
Haematology Research
Clinical Sciences
T +61393455161
E paul.monagle@mcri.edu.au

 

Available as Masters Project: No

Thrombosis in children is an ever-increasing problem. The two most common clinical presentations in children are venous thromboembolism (VTE) or arterial ischaemic stroke (AIS). While VTE and AIS are very different clinical entities, they are linked pathophysiologically. Specifically, both diseases involve the pathological formation of a blood clot, which is in turn based on the dysregulation of the key haemostatic protein, thrombin. VTE has significant adverse outcomes for children who would otherwise survive their primary health problems unscathed. AIS is among the top ten causes of death in children and is associated with significant social and economic burden, as more than 50% of survivors have long-term neurological impairments. Reducing the rates of thrombosis and its associated sequlae in children represent major clinical challenges.


This project will investigate the haemostatic abnormalities and the mechanism of thrombosis in two extensively phenotyped core family cohorts of children with thrombosis (VTE and Stroke) and their asymptomatic siblings.

Note: Samples, clinically relevant and laboratory data for this study have previously been collected and the primary role of the Honours student will be to analyse this existing data. There is potential for a pilot laboratory study to be carried out during this Honours project.

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39. Understanding brain development in ADHD using longitudinal, multimodal neuroimaging

Doctor Charles Malpas
Developmental Imaging
Clinical Sciences
T +61399366433
E charles.malpas@mcri.edu.au

 

Available as Masters Project: Yes

The neurobiological substrate of attention deficit hyperactivity disorder (ADHD) is an area of active research. Compared to typically developing children, those diagnosed with ADHD demonstrate deficits on tasks of sustained, complex, and divided attention. A number of studies have reported differences in brain structure and function between children with ADHD and typically developing controls. As a part of the Neuroimaging of the Children's Attention Project (NICAP) study, we are in the process of collecting longitudinal neuroimaging data on children with and without ADHD from ages 9.5 to 12.5 years. The aim of this project is to investigate to what degree these differences in brain structure and function explain the observed cognitive impairments.

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 40. Peak exercise capacity in patients with a Fontan circulation

Dr Rachael Cordina
Royal Prince Alfred Hospital/University of Sydney
T 0414984030
E Rachael.Cordina@Sydney.edu.au

 

Available as Masters Project: No

Some of the most severe congenital heart abnormalities result in single functioning ventricle. Many children born with these defects undergo a series of operations to help them survive that ultimately results in a Fontan circulation, where venous return through the lungs bypasses the heart. Although improvements in surgical and medical care have resulted in improved survival, exercise capacity is reduced and may deteriorate over time. While North American data has demonstrated a slow deterioration in peak oxygen uptake, serial assessment of peak exercise capacity, measured with cardiopulmonary exercise testing has not been reported in a large Australian cohort. 

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41. Placental dysfunction in the causal pathway to cerebral palsy

Available as Masters Project: Yes

Cerebral palsy affects about one in 500 children, however in most cases the exact cause is unknown. We hypothesise that in some cases of CP, placental dysfunction in early pregnancy is part of the causal pathway to CP. This project will involve data linkage between two large and existing databases. The first is the Victorian Cerebral Palsy Register, which collects clinical and epidemiological data for Victorian children with cerebral palsy. The second is the Victorian Clinical Genetics Services Maternal Screening service, which undertakes testing of most pregnant mothers in Victoria. Although this testing is focused primarily on screening for Down syndrome, bHCG and PAPP-A measurements can also be used as a measure of placental dysfunction. We hypothesize that compared with pregnancies that result in a non-CP child, pregnancies that result in the birth of a child with CP will have different levels of bHCG and PAPP-A. In addition these differences may vary with the sub-type of CP. If such differences are detected, bHCG and PAPP-A levels could be used to identify pregnancies at risk of CP, providing the potential for intervention and prevention. 

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42. Cardiovascular Risk in Nephrotic Syndrome

Available as Masters Project: Yes

The damage to arteries that eventually leads to cardiovascular disease (e.g. heart attack and stroke) starts in early childhood. Identification of those at highest risk early in life offers a considerable potential to reduce adult cardiovascular disease. Nephrotic syndrome is a poorly understood condition characterised by massive urinary protein loss, resulting in swelling of subcutaneous tissues (oedema), and abnormal blood lipids. It affects about 15 children per year at the Royal Children's Hospital. There are limited data suggesting that nephrotic syndrome may be associated increased long term cardiovascular disease risk, but definitive studies are lacking. This study will investigate whether children who have had nephrotic syndrome 5-15 years previously have markers of increased CVD risk, compared to healthy controls. Cardiovascular disease risk will be assessed using non-invasive techniques, including blood pressure and ultrasound, as well as blood markers. The findings will enable identification of children who are at increased cardiovascular disease risk, and explore the underlying biological mechanisms. The long-term goal is to identify those at heightened risk early and develop interventions that aim to reduce the potential later risk burden, by minimising vascular injury early in the disease. The student will work within an interdisciplinary team of medical researchers (including a ultrasound research technician) and will coordinate/perform patient recruitment, data collection and analysis. 

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60. A qualitative study exploring physical activity in children with a Fontan circulation

Doctor Karin Du Plessis
Heart Research
Clinical Sciences
T +61393456161
E karin.duplessis@mcri.edu.au
Dr Rachael Cordina
Cardiology
Royal Prince Alfred Hospital
T 0414984030
E rachael.cordina@sydney.edu.au

Available as Masters Project: Yes


Some of the most severe congenital heart abnormalities result in single functioning ventricle. Many children born with these defects undergo a series of operations to help them survive that ultimately results in a Fontan circulation, where venous return through the lungs bypasses the heart. Although improvements in surgical and medical care have resulted in improved survival, exercise capacity is reduced and may deteriorate over time. Limited evidence has suggested that exercise training is the most effective intervention for improving exercise performance and cardio-vascular health in those with a single ventricle. While we all know that exercise is good for you, and we have now identified that exercise is safe in Fontan patients, a solid evidence base is non-existent. We want to provide a source of information, in the form of a school brochure, for children, parents and teachers as a guide to the types of physical activity and exercise children can participate in.

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61. Understanding prognosis for children diagnosed with autism spectrum disorder

Available as Masters Project: Yes


One of the first questions that parents ask after their child has been diagnosed with autism is "what will their future be like?". They also want to know what factors might influence important health and wellbeing outcomes over their child's life. These questions are currently difficult to answer. Through systematic review and meta-analysis of existing data about outcomes of children with autism we hope to develop a greater understanding of important outcomes and factors associated with them, like intelligence and ability to talk, for individuals with autism.

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62. Characterising Autism Spectrum Disorder in identical twins

 

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63. How do we help sick babies breath? Understanding the role of ventilator synchronisation on lung protection

Doctor Prudence Pereira
Neonatal Research
Clinical Sciences
T +61383416452
E prue.pereira@mcri.edu.au

Available as Masters Project: Yes


The diseased newborn lung is particularly prone to injury that can persist throughout life. Increasingly, we are aware that allowing a mechanical ventilator to synchronise with a baby's own breathing pattern reduces the risk of lung injury. Ventilation within the diseased lung is complex and rarely the same throughout the lung. This project aims to understand how synchronisation influences the behaviour of tidal ventilation throughout the lung. It will involve directly studying newborn babies receiving Intensive Care at the Royal Children's and Women's Hospitals using advanced lung imaging techniques. The student will take detailed recordings of lung mechanics and ventilation in babies receiving mechanical ventilation and describe the breath-to-breath characteristics of synchronised and unsynchronised breaths to determine whether lung protection is being achieved and whether it is uniform within the lung. 

 

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Data Science

64. Machine learning methods for causal inference in epidemiology: Application to the effects of cannabis use on mental health

Available as Masters Project: Yes


Biostatistics is a core discipline of public health research. It comprises all statistical methods for the design and analysis of studies that use data to answer questions about the health of populations. At the interface of health and data science, it provides an exciting opportunity for candidates from Mathematics and Statistics majors to invest their unique skills in advancing the development and application of methods for understanding human health. This biostatistics project focuses on the implementation of causal inference methods incorporating machine learning, in the context of a study of the effects of cannabis use on mental health. The study uses data from the Victorian Adolescent Health Cohort Study, a longitudinal cohort study of almost 2000 participants for whom large amounts of data have been collected across 10 waves over the past 20 years. This rich and complex data source has the potential to provide key insights into the effects of cannabis use, but traditional analytic approaches using standard regression models can be overly simplistic and may not validly reflect the full complexity of the data. Recently, it has been proposed that data-adaptive (machine learning) methods could be used in such contexts, by combining them with causal inference approaches such as propensity score and standardisation methods, which are widely used in epidemiology. The aim of this project is to implement, compare and assess these methods in the cannabis use study, providing an illustration and potentially a set of guidelines for practitioners who wish to apply them in their studies.

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65. Evaluation and development of approaches for conducting sensitivity analyses within the multiple imputation framework

Available as Masters Project: Yes


The proposed project will investigate issues regarding the use of multiple imputation to handle missing data in longitudinal studies. In particular, the project will involve a review and implementation of methods for conducting sensitivity analyses regarding the mechanism behind the missing data, to allow for the possibility that missingness may depend on unobserved data, with the aim of developing guidance for reporting the results of such analyses. This is a very topical area of research. The research will engage directly with analyses from the Longitudinal Study of Australian Children, a nationally representative longitudinal study of 10,000 children managed by the Department of Social Services on behalf of the Australian Government. The successful candidate will be based at the Murdoch Childrens Research Institute. The candidate will be supported by the broad research group of the Victorian Centre for Biostatistics (ViCBiostat). See the ViCBiostat website (http://www.vicbiostat.org.au/) for more information on our group's research program on missing data and multiple imputation. Graduates with majors in biostatistics or statistics are encouraged to apply. Please contact Assoc/Prof Katherine Lee katherine.lee@mcri.edu.au or Dr Margarita Moreno-Betancur maargarita.moreno@mcri.edu.au for more details

 

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Genetics

43. What are the education and training needs of health professionals incorporating genomics into healthcare? A mixed methods study

Doctor Amy Nisselle
Genetics Education & Health Research
Genetics
T +61399366340
E amy.nisselle@mcri.edu.au

 

Doctor Belinda McClaren
Genetics Education & Health Research
Genetics
T +61383416415
E belinda.mcclaren@mcri.edu.au

 

Doctor Clara Gaff
Developmental Disability and Rehabilitation Research
Clinical Sciences
E clara.gaff@mcri.edu.au

 

Available as Masters Project: Yes

The Australian Genomics Health Alliance (Australian Genomics), funded by the NH&MRC, brings together more than 70 partner organisations committed to integrating genomic medicine into healthcare across Australia (www.australiangenomics.org.au). Australian Genomics aims to shorten diagnosis times, enable early intervention and provide access to treatment for people with genetic disorders by translating genomic technology into clinical practice for patients and family benefit. Within Australian Genomics, Program 4 is conducting research around education and training needs of the genomic workforce, as well as ethical and patient perspectives of genomic medicine. The Program 4 working group consists of experts in genetics/genomics education, clinical practice, evaluation, mixed methods research, genetic counselling, social science, science communication and ethics.

The aim of this project is to inform strategies around education and training of health professionals to enable them to incorporate genomic medicine into their future practice. The project is suitable for two Honours students or one Masters student. Student/s will use a mixed methods approach, combining interviews and surveys to gather data from a range of perspectives, including health professionals, genomic specialists, educators, patient groups, professional organisations and other stakeholders. Student/s will be trained in quantitative and/or qualitative methods to develop needs assessment surveys and/or interview schedules based on existing literature and other data obtained by Program 4. For the survey component, the student would develop a draft online survey which would then undergo a process of iterative revision with content and educational experts (a process known as the Delphi technique), piloted then deployed and analysed using descriptive and inferential statistics. For interviews, student/s would be trained in developing an interview schedule, interviewing technique and qualitative data analysis, such as inductive thematic analysis.

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44. Susceptibility to adult disorders in carriers of Mendelian alleles

Dr Sarah Stephenson
Neurogenetic Research (BLC)
Genetics
T +61399366563
E sarah.stephenson@mcri.edu.au

 

Available as Masters Project: Yes

The most common and pervasive human health problems are caused by diseases with complex aetiologies. Humans differ greatly in their genetic vulnerability to these common diseases. Mechanisms that underlie disease susceptibility and progression are, with few exceptions, influenced by numerous genetic, developmental and environmental factors. For the most part, complex disorders are difficult to study and treat because the specific factors that cause most of these disorders have not yet been identified.
By contrast, Mendelian or monogenic disease are caused by mutations in one gene and they often run in families and can be dominant or recessive, and autosomal or sex-linked. It is recognised that complex disorders also often cluster in families but they do not have a clear-cut pattern of inheritance. This makes it difficult to determine a person's risk of developing disease.
One way to investigate the genes associated with complex disease is genome-wide association study (GWAS). GWAS investigate the entire genome and identify SNPs and other variants in DNA associated with a disease, but they cannot on their own specify which genes are causal. We hypothesise carrier status of a gene that is known to causes a Mendelian childhood illness will increase and individuals risk for adult onset illness. To date, hundreds of GWAS on thousands of individuals with diverse disease have been performed and to our knowledge no one has interrogated them to determine if there is an over-representation of known disease genes.

In the project the candidate will interrogated the literature and publically housed genetic databases to determine if there is a correlation between genes that cause childhood Mendelian disease and the genes that cause complex adult onset disease.

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45. Burden of disease associated with genetic aetiology at a paediatric hospital 

Professor Agnes Bankier
RCH Ethics
T 9345 5044
E Agnes.Bankier@rch.org.au

 

Available as Masters Project: No

It is well recognised that genetic disorders contribute significantly to paediatric mortality and morbidity. Previous audits (unpublished) carried out at the Royal Children's Hospital (RCH) show that individuals with genetic conditions make up a significant proportion of the hospital population and often have longer and more frequent hospital stays. The aims of this study are to 1) determine the proportion of admissions to the RCH in a 2- week sample of patients in 2017 that have a genetic component, using nine genetic 'load' categories previously determined; 2) describe characteristics of inpatients with these genetic conditions and their hospitalisation; 3) identify the number of RCH patients who were referred to or received consultations with Victorian Clinical Genetic Services (VCGS) and 4) determine whether there have been any changes in these observations over four sample time periods of 1985, 1995, 2007 and 2017. Awareness of the past and current magnitude of the influence of genetic load on hospital admissions is important for health service planning and for monitoring the influence of new genetic technologies on future paediatric hospital admissions. 

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66. Developing new sensitive outcome measures for assessment of gait in children and adolescents with Angelman syndrome

Doctor Claudine Kraan
Cyto-molecular Diagnostics Research
Genetics
E claudine.kraan@mcri.edu.au

Available as Masters Project: Yes


Angelman syndrome is genetic neurodevelopmental disorder characterised by communication difficulties, developmental delay and tremulous movements with ataxic gait. The few studies of motor function in Angelman syndrome have led to disagreement about overlap with cerebral palsy and/or spastic diplegia, and there is a paucity of objective data available about the specific gait characteristics of Angelman syndrome. This limits understanding of the natural history of Angelman syndrome and makes it difficult to stratify participants in clinical trials based on motor functioning. This project will focus on development of protocols to quantify gait in children with Angelman syndrome using wireless inertial sensors. The measures collected will include gait velocity, cadence, asymmetry, and intra-step variability, both at baseline (normal walking), and where appropriate, during concurrent performance of cognitive tasks (normal walking with dual task interference). The student will assess 30 ambulatory Angelman syndrome participants < 18 years old (~50% female) from our existing larger genotype-phenotype Angelman syndrome study (the FREE FX Study) and 30 newly recruited age-matched control children. As part of this project the student will examine for the first time how well gait measures are correlated with previously collected formal cognitive and behavioural variables in children with Angelman syndrome, as well as SNRPN promoter methylation and expression variables. This investigation will yield important information about the type and extent of neurological dysfunction in Angelman syndrome-affected children, as well as provide novel insights into the molecular pathways/aetiology's underlying the neurocognitive phenotype of Angelman syndrome. Given that gait assessment is a relatively easy approach to assessing neurological function in developmentally delayed children, the project's outcomes may have significant translational potential as biomarkers of disease severity in future studies.

 

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Infection and Immunity

46. BiliNappy: Novel low cost point-of-care diagnostic for Jaundice embedded in a newborn nappy 

Available as Masters Project: Yes

Severe jaundice is a life threatening condition. Currently, the diagnosis of neonatal jaundice requires a blood test. Bilirubin blood testing is routine in both provincial and tertiary referral hospitals. For remote locations and developing economies this diagnostic testing is not readily available leading to delays in treatment. There is an urgent need to identify a suitable, reliable and affordable bedside test to positively impact upon the lives of millions of children worldwide by facilitating effective early intervention. Our group has developed a non-invasive, affordable (~AUD$0.10 per test), bedside test for neonatal jaundice using a urine detection method placed in a newborn's nappy, referred to as BiliNappy. This project will evaluate the reliability of BiliNappy and to determine its usefulness in maternal units as a screening method in newborn infants susceptible to treatment. The student will use biochemical sensing methods to quantify the bilirubin in urine. The techniques developed will be validated against gold standard methods of diagnosis using blood tests. This project is a collaborative effort between Engineering, Chemistry and Clinical sciences. 

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47. Risk factors associated with pneumococcal carriage in healthy children in Mongolia prior to pneumococcal conjugate vaccine introduction 

Assoc. Prof Fiona Russell
Pneumococcal Research
Infection and Immunity
T +613 9345 4077
E fmruss@unimelb.edu.au

 

Doctor Claire von Mollendorf
Pneumococcal Research
Infection and Immunity
T +613 9936 6773
E claire.vonmollendorf@mcri.edu.au

 

Available as Masters Project: No

Pneumonia is the leading infectious cause of mortality in young children with 95% of deaths occur in low- and middle-income countries. Streptococcus pneumoniae is amongst the commonest causes of acute respiratory infections. Nasopharyngeal pneumococcal carriage is considered the precursor to disease and carriage rates vary by age with the highest rates reported in children. Carriage rates also vary in different settings and countries. We have ongoing surveillance and studies in Mongolia to define the impact of pneumococcal vaccine introduction on pneumococcal disease and carriage in this country. In this study we hope to determine risk factors for carriage in children in this country.

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 54. Biomarkers of human papillomavirus-related cancers

Doctor Dorothy Machalek
Molecular Microbiology
Infection and Immunity
T +61383453680                                                                                                                                                 E dorothy.machalek@mcri.edu.au

 

Doctor Monica Lugue

 

Available as Masters Project: Yes

Human papillomavirus (HPV) causes cervical, other anogenital, anal and skin cancers. Many people who eventually develop HPV-related cancer were first exposed to HPV in adolescence or young adulthood, with cancers taking decades to develop. Early detection of precancers or small cancers improves prognosis and quality of life. HPV-associated cancers disproportionately affect disadvantaged and/or marginalised populations such as Australian Indigenous and Torres Strait Islander peoples (ATSI), women in low- and middle-income countries (LMIC), immunocompromised and/or HIV-positive people, and gay and bisexual men (GBM). Prevention of cervical cancers has been very successful in higher-income countries such as Australia using intensive, technically-demanding screening programs, however these types of screening programs are unfeasible in many low-resource settings, and are more technically difficult for other HPV-related cancers such as anal cancer. The identification and development of simple to implement, sensitive and specific biomarkers for cancer risk in HPV-positive individuals has the potential to significantly decrease the burden of these cancers. Cancer development is preceded by certain molecular changes; these include epigenetic modifications such as methylation of viral gene promoters, and changes to the expression of viral and cellular gene products. This project will involve the characterization of molecular patterns in clinical samples from people with and without HPV-related disease – including cancer - with a view to determining the potential of each marker to contribute to effective screening for people at risk of HPV-related cancer. This project will involve laboratory work in the Molecular Microbiology Department of the Royal Women's Hospital, including nucleic acid purification, polymerase chain reaction (PCR) including real-time PCR, digital droplet PCR, reverse transcriptase PCR to detect messenger RNA (mRNA) transcripts, epigenetic studies including detection and quantification of methylation, and others.  Data entry, database design and data manipulation including the possibility of some basic programming, and statistical analysis in the Stata statistics package, will be important for this project. Other tasks may involve co-ordination of sample collection, receipt and processing. For longer projects (i.e. PhD, Masters), additional tasks may include assay design and development, and application and/or reporting for ethics approvals. The RWH Molecular Microbiology Department is affiliated with the University of Melbourne, the Royal Women's Hospital, the Royal Children's Hospital and Murdoch Childrens Research Institute. We collaborate with numerous other institutions in Australia and internationally including primary health care, research institutions, and private industry including private pathology and biotechnology/pharmaceutical companies, with numerous opportunities for multi-disciplinary engagement.

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Population Health

48. What influences mental health treatment choices for children in Australia? A qualitative study of family and clinician factors

Ms Melissa Mulraney
Community Health Services Research
Population Health
T +61399366628
E melissa.mulraney@mcri.edu.au

 

Professor Lynn Gillam
Children's Bioethics Centre
The Royal Children's Hospital
T 9345 4368
E lynn.gillam@rch.org.au

 

Available as Masters Project: Yes

Background: Treatment for mental health problems in children varies greatly. Some children get lots of care whilst others get very little. Clinician and family factors likely contribute to variation in care. Modifying these factors could reduce variation, but this requires accurate understanding of which factors to modify.

Aim: To identify potentially modifiable clinician and/or family factors associated with variation in treatments provided to children with the most prevalent mental health disorders (i.e., attention deficit/hyperactivity disorder [ADHD], anxiety, depression) in low versus high socioeconomic areas and in major city versus other locations.

Study: Nested within an NHMRC project grant, this study will collect qualitative data from in-depth one-on-one interviews (approximately 30-45 mins duration) with clinicians (GPs, paediatricians, psychologists, and child psychiatrists) and/or caregivers of children diagnosed with ADHD, anxiety or depression.

Data collection: Data are being collected from clinicians and/or caregivers in Victoria and South Australia, from a spread of socio-demographic areas, major city/regional areas, and public/private settings. The students will be involved with active data collection including contacting potential participants, conducting qualitative interviews, and data entry, cleaning, and analysis.

Measures: The interview questions will explore a range of factors (e.g., clinician knowledge of best practice care, availability of other clinicians to whom to refer, barriers for parents accessing treatment such as cost, stigma, wait lists) and also to uncover previously unreported influences, such as established local practices, social and school contexts, and personal beliefs and values.

Analyses: Interview data will be analysed qualitative methods using a software program called NVivo. Students will be provided with close supervision and guidance during the analysis process. Students will be able to choose an aspect of the project (eg interviews with families in rural areas or interviews with psychologists in low socioeconomic areas etc) which suits their interest.

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49. The epidemiology of childhood food allergy and other allergic diseases

Doctor Rachel Peters
Gastro & Food Allergy
Population Health
T +61399366413
E rachel.peters@mcri.edu.au

 

Available as Masters Project: No

An epidemic of allergic diseases has occurred, marked by the rapid rise of asthma, eczema and allergic rhinitis during the 1990s, followed by an alarming increase in food allergies in the 2000s. The determinants, natural history and impact of allergic diseases, in light of the increased prevalence, remains largely unknown. This includes whether the new wave of infant food allergy will persist into childhood, and the role of food allergy in the development of other allergic diseases such as asthma.

The HealthNuts study is the world's largest population-based, longitudinal study of food allergy and other allergies in early childhood. At 12-months of age, 5300 infants underwent skin-prick testing, and all positives proceeded to hospital-based food challenges to test for food allergy. The cohort has been followed up at ages 4 and 6 years and an age 10 year follow-up is underway. Objective data on the full range of allergic outcomes (asthma, eczema, allergic rhinitis and food allergy) including lung function testing, food challenges and skin prick tests, as well as other measures of their physical and psychosocial health, and healthcare utilisation across the early years, will be available.

A position is available for an honours student to investigate a number of potential research questions related to the determinants, natural history and consequences of food allergy and other allergic diseases. This is an exciting opportunity to undertake epidemiological research in a large, longitudinal study. Possible research projects include:
- To explore the role that infantile food allergy plays in the development of other allergic diseases
- To determine which children with early-life wheezing will go on to develop asthma
- To describe the prevalence and identify risk factors of food and aeroallergen sensitisation in a population-based cohort

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50. Measuring low value care across inpatient, outpatient and emergency department settings

Ms Rachel Neely
Community Health Services Research
Population Health
T +61399366052
E rachel.neely@mcri.edu.au

 

Available as Masters Project: Yes

Low value, or unnecessary care, is care that provides little or no benefit, may cause patient harm, or yields marginal benefits at a disproportionately high cost. Identifying and reducing low value care is now an international priority for a sustainable healthcare system (e.g. Choosing Wisely campaign). For example, in children, the use of chest x-rays is considered unnecessary for the diagnosis of asthma, yet these tests are still conducted. Unnecessary testing may cause harm to the child (radiation) and the healthcare system (increased costs).

To identify an instance of low value care at the Royal Children's Hospital (RCH), and to measure for these tests (i) the frequency across ED, inpatient and/or outpatient settings; (ii) the costs to the hospital/patient; and (iii) factors associated with unnecessary testing (eg. child, clinician or setting).

In a sample of children at the RCH, the proportion of unnecessary testing will be high for common conditions, and factors associated with unnecessary testing will include child age (younger child), clinician factors, and setting (ED, OP, IP). 3-month prospective audit drawing upon RCH patient data recorded in Epic. Patients with planned admissions for chronic illnesses (eg chemotherapy) will be excluded. Bivariate and logistic regression analysis to determine child (eg age, gender, family SES), clinician and other factors (eg seasonality) associated with unnecessary testing. Cost analysis of unnecessary testing, scaled up to healthcare system costs over 1 year. Interest and time permitting, interviews with 5 key hospital clinicians to determine why they request unnecessary testing.

Before trialling interventions to reduce unnecessary testing, we first need to identify which children and which conditions are associated with unnecessary testing and any potentially modifiable risk factors associated with such tests. Results will inform a peer-reviewed publication and planned intervention trials to reduce unnecessary testing.

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51. Measuring low value care in the emergency department; a multi-site study

Ms Rachel Neely
Community Health Services Research
Population Health
T +61399366052
E rachel.neely@mcri.edu.au

 

Available as Masters Project: Yes

Low value, or unnecessary care, is care that provides little or no benefit, may cause patient harm, or yields marginal benefits at a disproportionately high cost. Identifying and reducing low value care is now an international priority for a sustainable healthcare system (e.g. Choosing Wisely campaign). For example, in children, the use of chest x-rays is considered unnecessary for the diagnosis of asthma, yet these tests are still conducted. Unnecessary testing may cause harm to the child (radiation) and healthcare system (increased costs).

To identify low value care in emergency departments (ED) at 1-4 hospitals, and to measure for these tests, at each site (i) the frequency of low value testing; (ii) the costs to the hospital/patient; and (iii) factors associated with unnecessary testing.

In a sample of children presenting to ED at multiple hospitals, the proportion of unnecessary testing will be high for common conditions, and factors associated with unnecessary testing will include child age (younger child), clinician factors, and hospital type (general or paediatric).

3-month prospective audit drawing upon data recorded in ED electronic records at each site. Patients with complex conditions will be excluded. Bivariate and logistic regression analysis to determine child (e.g. age, gender, family SES), clinician and other factors (eg seasonality) associated with unnecessary testing. Cost analysis of unnecessary testing, scaled up to healthcare system costs over 1 year. Interest and time permitting, interviews with 5 key hospital clinicians to determine why they request unnecessary testing.

Before trialing interventions to reduce unnecessary testing, we first need to identify which children and which conditions are associated with unnecessary testing and any potentially modifiable risk factors associated with such tests. Results will inform a peer-reviewed publication and planned intervention trials to reduce unnecessary testing.

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52. The feasibility and acceptability of a mindfulness meditation program within the preschool setting 

Doctor Jane Sheehan
Community Health Services Research
Population Health
T +61383416384
E jane.sheehan@mcri.edu.au

 

Available as Masters Project: Yes

The use of mindfulness meditation and mindfulness based curriculum has become increasingly popular in primary and secondary schools. There is less evidence detailing the use of mindfulness meditation in the pre-school years and the impact such programs may offer in fostering mental health, wellbeing and early learning skills in young children.

To evaluate the feasibility, acceptability and fidelity of a newly developed mindfulness program within early learning centres (ELCs)

This pilot study will be conducted in ELCs to assess the content useability of a newly developed mindfulness program. The study will examine educator fidelity with the program content, their experience of the program, their sense of competence using the program and their knowledge of mindfulness practice since implementation. Data will be collected from early childhood educators, via online questionnaires and qualitative interviews.

The measures used in this study will likely on educator experience, satisfaction, and content knowledge. The interview questions will explore educator's experience of the mindfulness program. Quantitative measures will be scored/interpreted as required by the measure, while interview data will be analysed using thematic analysis. Students will be provided with close supervision and guidance during the analysis process. 

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53. The 'Premmie Health Profile': Do babies born early or small have distinct patterns of health and metabolic disparities?

Available as Masters Project: Yes

Premature birth and being born small for gestational age (SGA) are costly to the healthcare system and elicit substantial concern amongst parents and clinicians. There is increasing interest in those born late preterm and early term, who make up a significant proportion of total births. Preterm children are more likely to experience health, cognitive and academic deficits than their peers in early childhood. Most studies evaluate outcomes in one domain but not multiple domains simultaneously in a single cohort to look for a cross-domain profile associated with prematurity.


Aside from being premature, being born small at any gestational age may also have a lasting legacy on later health. Previous studies have focussed on SGA children, but there may be impacts on later health across the full continuum of gestational size.
In a large national cohort of Australian 11-12 year old children, we will investigate the cross-domain profile associated with gestational age and birth weight, considering physical health, metabolomics, psychosocial and cognitive domains.
The Longitudinal Study of Australian Children (LSAC) is a national, population-derived cohort of Australian children.

Commencing in 2004, soon after the children were born, the study has assessed the children and their families every two years, and in 2015-16, conducted a comprehensive physical health assessment and biosample collection module called the Child Health CheckPoint. This project will utilise pregnancy and birth data from LSAC Wave 1 (child age 0-1 year), cognition, academic outcome and emotional/mental health data from LSAC Wave 6 (10-11 years), and physical health (cardiovascular, renal, bone, respiratory, body composition) and biologic data from the CheckPoint (11-12 years). The project will suit someone interested in health, epidemiology and/or statistics, and working closely with a strong interdisciplinary team. Given the large, high quality data available, findings are likely to be published in a quality journal.

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55. The "Best Age and Size to be Born": Is there an optimal gestational age and size for later child health, and does this vary by specific health and metabolic outcome?

Available as Masters Project: Yes


Premature birth and being born small for gestational age (SGA) are costly to the healthcare system and elicit substantial concern amongst parents and clinicians. While previous studies have focussed on early pre-term and SGA children, there is increasing interest in those born late preterm and early term, who make up a significant proportion of total births. Being born early or small is associated with poorer outcomes in childhood health, cognition and academic achievement than average gestational age and size children, but little is known about the optimal gestational size and age associated with outcomes, and how this association varies across the physical and psychosocial health and cognition domains. In a large national cohort of Australian 11-12 year old children, we will investigate the how physical health, metabolomics, psychosocial and cognitive domains are associated with gestational age and birth weight across the continuum, and determine the optimal age and size for later child health over all, and by specific health or metabolic outcome. The Longitudinal Study of Australian Children (LSAC) is a national, population-derived cohort of Australian children. Commencing in 2004, soon after the children were born, the study has assessed the children and their families every two years, and in 2015-16, conducted a comprehensive physical health assessment and biosample collection module called the Child Health CheckPoint. This project will utilise pregnancy and birth data from LSAC Wave 1 (child age 0-1 year), cognition, academic outcome and emotional/mental health data from LSAC Wave 6 (10-11 years), and physical health (cardiovascular, renal, bone, respiratory, body composition) and biologic data from the CheckPoint (11-12 years). The project will suit someone interested in health, epidemiology and/or statistics, and working closely with a strong interdisciplinary team. Given the large, high quality data available, findings are likely to be published in a quality journal.

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56. What does it cost to do research with women experiencing adversity?

Available as Masters Project: Yes


Recruitment and retention of participants in large-scale, longitudinal, health services research can be challenging. This is especially so when the cohort is selected for their experience of socioeconomic, psychosocial or health adversities. Longitudinal research can require time, effort and cost burdens related to understanding and providing informed consent and making oneself available for multiple research assessments. This can be difficult for individuals with less stability in their lives or less confidence, literacy or familiarity health services. However, given that individuals experiencing adversity also have the greatest need for supports, it is critical that research adequately engages representative cohorts so that findings can be used to enhance the effectiveness of service provision, and in turn reduce established health disparities.

In Australia, where government research funding is highly competitive and grants are often underfunded, research with cohorts experiencing adversity can be overlooked because of the considerable funding required to engage and retain participants. The right@home project began in 2013 and comprises a large cohort of Australian women (N=722) selected for their experience of adversity during pregnancy, who are followed regularly until children start school. This student project will aim to calculate the true costs of longitudinal research with this cohort. Ideally, the findings will help other research groups capitalize on opportunities for research with cohorts experiencing adversity which, while challenging and expensive, are crucial for delivering effective health services to the individuals who need them most.

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57. Understanding patterns of social adversity from pregnancy to school-entry

Available as Masters Project: Yes


A range of parental risk factors such as low socioeconomic status, single parenthood, low educational attainment and poor mental health have been associated with poorer cognitive, language and socioemotional outcomes in Australian children. Parental risk factors commonly co-occur, and the severity of children's later problems increases as the number of risk factors increases. Importantly, there is a clear social gradient in the distribution of these risk factors. Families experiencing the greatest social adversity report a higher number of, and more severe, risk factors, and their children have the poorest outcomes. Adverse early childhood trajectories track into adolescence and correspond to poorer educational attainment, income and health throughout adulthood.

Given that many risk factors associated with adversity are potentially modifiable, it may be possible to improve outcomes for both women and children, and reduce or prevent the social gradient, by identifying women at risk and providing them with sufficient and effective supports and resources. The right@home trial recruited a large cohort of Australian women for their experience of adversity in pregnancy and conducts detailed assessments with women and their subsequent children until children start school. Within this trial, there is an exciting opportunity for a MASTERS or PhD student to examine whether there are patterns of risk factors that persist over time, and how they are associated with women's and children's outcomes. Understanding patterns of risk factors could help early years' professionals better identify children at risk of poorer outcomes and, ideally, help inform services to reduce the negative impact of these early risks.

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58. How is hair cortisol related to mother's mental health and wellbeing over time?

Miss Hannah Bryson
Policy, Equity & Translation
Population Health
T +61393456168
E hannah.bryson@mcri.edu.au

Available as Masters Project: Yes

Women in their first years after giving birth are at greater risk of poor mental health. This is particularly the case for women who are also experiencing social adversity, such as low socioeconomic status, single parenthood, and low educational attainment. The biological stress response system is one proposed pathway by which adversity leads to poorer mental health. The hypothalamic-pituitary-adrenal axis, and its production of the hormone cortisol are thought to play a pivotal role in this process. Short-term changes in cortisol production have been associated with mental health diagnoses of anxiety and depression. However, little is known about long term patterns of cortisol production and the associated mental health outcomes. Measuring cortisol concentrations in hair is a relatively new method which offers the potential for examining these patterns over time.

The right@home trial recruited a large cohort of Australian women for their experience of adversity in pregnancy and conducts detailed assessments with women and their subsequent children until children start school. Within this trial, there is an exciting opportunity for a Honours or Masters student to examine patterns of hair cortisol concentrations in mothers when their children are 1, 2 and 3 years old, and women's subsequent mental health at child age 3 years. The findings of this study will help to understand the role of the physiological stress response in mental health and contribute to the relatively new body of literature examining the use of hair cortisol in large population health trials.

 

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59. Validating a generic mood question in a large cohort of Australian women

Professor Lynn Kemp
Western Sydney University
Ingham Institute
T 02 8738 9387
E Lynn.Kemp@westernsydney.edu.au
Ms Francesca Orsini
Clinical Epidemiology & Biostatistics (CEBU)
Data Science
T +61393454744
E francesca.orsini@mcri.edu.au

Available as Masters Project: Yes


Australian clinical practice guidelines for antenatal care recommend assessing women's mental health during pregnancy; however, popular measures tend to assess depression or anxiety, rather than mental health more generally. The Matthey two-item Generic Mood Question was designed to assess the presence of any emotional difficulty during pregnancy. The short measure has shown good correlation with longer, validated anxiety measures including the Edinburgh Postnatal Depression Scale and the Hospital Anxiety Depression Scale. This student project aims to validate the Matthey Generic Mood Question against the reliable, validated Depression, Anxiety, Stress Scale (DASS 21-item short-form). Data will be drawn from the right@home trial, which recruited a large cohort of Australian women (N=722) selected for their experience of adversity during pregnancy.

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